NRD to Predict COPD Exacerbations at Home

Launched by GUY'S AND ST THOMAS' NHS FOUNDATION TRUST · Feb 16, 2018

Keywords

ClinConnect Summary

Introduction

COPD is a common and serious disease, and is a major burden on patients and the National Health Service. Current markers to detect and monitor exacerbations and response to treatment are based on symptoms reported by patients, clinical assessment and Early Warning Scores, which are a composite measurement of standard observations, including heart rate, blood pressure, respiratory rate and oxygen saturations. However these scores have been validated on general populations and there is concern regarding their application to COPD patients. There is currently no objective biomarke...

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Eligibility criteria

• Inclusion Criteria:
• • Age 40-80 years
• • Patients hospitalized with a primary diagnosis of an acute exacerbation of COPD
• • Body mass index (BMI) ≤ 35 kg/m2
• • Cognitively and linguistically able to follow instructions given in English and provide informed consent
• • To be discharged to home following the hospitalization
• • Patient lives in the catchment area served by the Integrated Respiratory Team at Guy's and St Thomas' NHS Foundation Trust in a home environment deemed safe by the investigators to perform home assessments
• Exclusion Criteria:
• • Previous home PAP (CPAP or NIV) therapy use within the past year, or post-discharge
• • Allergies to latex, metals or local anaesthetic agents
• • Wound or inflamed skin at parasternal location (2nd intercostal space)
• • History of skin allergies or sensitivity to cosmetics and lotions
• • Psychological and social factors that would impair compliance with study protocol and schedule
• • Any major non-COPD chronic disease or condition, such as severe heart failure (LVEF\<30%), malignancy (active treatment and palliation), end stage renal failure/dialysis, significant neuromuscular disease (e.g. NMD, MD) determined by review of medical history and / or patient reported medical history that may contribute significantly to risk of readmission, as determined by PI
• • Length of stay ≤ 24 hours
• • Planned travel away from home within the 30 day post discharge period